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Quantitative left ventricular mechanical dyssynchrony by magnetic resonance imaging predicts the prognosis of dilated

Yong Yuan1, Jinghua Sun2, Dongsheng Jin3

  • 1Department of Magnetic Resonance Imaging, Cardiovascular Imaging and Intervention Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; Department of Diagnostic Imaging, Geriatric Hospital of Nanjing Medical University, Nanjing 210024, China.

European Journal of Radiology
|May 14, 2023
PubMed

Insights

Cardiovascular magnetic resonance imaging (CMR) can quantify left ventricular (LV) mechanical dyssynchrony in dilated cardiomyopathy (DCM) patients. This dyssynchrony parameter, 16SDTTPRS, independently predicts adverse outcomes in DCM.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Biomedical Engineering

Background:

  • Left ventricular (LV) dyssynchrony is a known prognostic factor in dilated cardiomyopathy (DCM), typically assessed via echocardiography.
  • Quantitative assessment of LV mechanical dyssynchrony using cardiovascular magnetic resonance imaging (CMR) offers a novel approach.

Purpose of the Study:

  • To investigate the predictive value of quantitative LV mechanical dyssynchrony, measured by CMR tissue feature tracking, for the prognosis of DCM.
  • To determine if CMR-derived dyssynchrony parameters offer superior prognostic information compared to traditional echocardiographic methods.

Main Methods:

  • Retrospective review of DCM patients who underwent CMR between January 2016 and December 2017.
  • Quantitative LV mechanical dyssynchrony assessed using CMR strain analysis, specifically the 16-segment standard deviation of the time-to-peak radial strain (16SDTTPRS).
  • Cox proportional regression analysis was employed to evaluate the association between LV mechanical dyssynchrony and patient outcomes.

Main Results:

  • A cohort of 417 DCM patients was analyzed with a median follow-up of 57 months.
  • 109 patients experienced composite endpoints, including cardiac death, heart transplantation, and ventricular arrhythmias.
  • Adjusted Cox regression revealed that 16SDTTPRS (HR, 1.932; P = 0.027), LV end-diastolic diameter index, NYHA class, and late gadolinium enhancement were independent predictors of adverse outcomes.

Conclusions:

  • Quantitative LV mechanical dyssynchrony, specifically the 16SDTTPRS parameter derived from CMR, is an independent predictor of adverse outcomes in DCM patients.
  • CMR-based assessment of LV mechanical dyssynchrony provides valuable prognostic information for managing DCM.
Abstract

Keywords:
Dilated cardiomyopathyLeft bundle branch blockMagnetic resonance imagingPrognosisStrain

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